I hate my health insurance

[LD1]

If the don't bill for the prenatal visits, there is nothing to pay cash for. And in the end, when I get the bill, it will be just 1 charge of $3100 under code 59400. So even paying cash and then turning in, they will not cover 100% of those visits. Cause the bill don't even reflect those visits.

 

[riptides]

I might add, a doctor of mine once forgave my exsiting bills owed to him. He told me to concentrate "on getting my life back together".

There were quite a lot of issues between him, my insurance company, and me. In the end, he cut me a break. He was tired of dealing with the insurance company too.

 

[Western]

I might add, a doctor of mine once forgave my exsiting bills owed to him. He told me to concentrate "on getting my life back together".

There were quite a lot of issues between him, my insurance company, and me. In the end, he cut me a break. He was tired of dealing with the insurance company too.

I'd say that doctor is a stand up guy! Normally they send it to collections and burn your credit.

Heres a short story I know for a fact:

BIL died of a heart attack 4 months ago. Last month his wife (SIL) is diagnosed with uterine cancer (advanced), she has 0 insurance and is basically broke. The quote she got from a N Texas hospital for their services was 34k, (estimated 3 day stay post OP) BUT since she has nothing, they will charge her 12k and change? The Doctors fee for the surgery would have been just under 7k, but they will do it in the $3,500 range. The difference is over 50%? She has purchased a surgical only insurance policy, but we haven't heard how this will effect the charges.

I submit to my fellow TBNers, that if the medical field would charge the lower rate ACROSS THE BOARD, this would certainly help this country's health care problem. I understand they may have to miss a vacation or 2, maybe use more tile in the Hospitals rather than carpet, and for some, it may be more difficult to get that extra "mountain house,,,but....Just thinking out loud.

For the record, I have 6 people in my immediate family in the medical professions.

 

[LD1]

I agree 100% about charging the lower rate across the board. It is stupid that the same procedure costs different amounts depending on who gets the bill.

The only thing it does is make those who have insurance think they are getting a good deal to stay in network. And absolutely gouging those out of network.

 

[Western]

Right! almost like "discrimination" against policy holders??

 

[Car Doc]

Congrats LD1 and I sure hope you dont end up bankrupt over it!

Imo this "mandatory insurance" situation is going to get a lot worse rather than better we have not even seen the tip of the iceberg I will leave it at that...

 

[dmccarty]

I find it hard to point the finger at the doctors office
hough. Cause they have do deal with dozens of carriers and hundreds of different policy variations. I understand that it would be impossible for them to know the ins and outs of every patients policy. And they have to have some sort of standard way they bill, and can't possibly do it differently for everyone.

And if I understand things correctly, they only bill the insurance company as a courtesy and are not obligated to do so.

I am starting to think that I would just be better off going in and saying I don't have insurance ( and get the cheaper rate), and when its all said and done, forward my expenses on to the insurance for reimbursement. No question I would still be out the $3k. But I met my 30% coinsurance would be less.

The service providers are handling the insurance today and one can debate if they should but they do. In your case, it does not sound like they are filing claims correctly. We have had a few problems with this but not many. Most of our issues with billing are with us NEVER getting a bill until the collection agency notifies us. This has happened several times from completely different providers. In the end there was no harm done but it ticks me off to say the least. We have also gotten bills that should have been sent 6-9 months prior. Your having to prepay for care has never happened with us. It is NOT common with the service providers we have used, and unfortunately, we have used quite a few service providers. We have been to three of the four major hospital groups as well as quite a few doctors. We have never prepaid for services.

After one surgery, the service provider set up a loan for us without any input from us at all. They just do it if certain thresholds are met. We were surprised when we saw the paper work about the loan. The loan in no interest so we are on a payment plan. :confused3: We asked if we paid cash would we get a discount, and the provider said no, so we are paying over time. That loan is free money and I like free money. :laughing::laughing::laughing:

The service provider may say it is a courtesy but the reality is that they have to submit the bills if they want to get paid in a timely manner.

We have left one doctor because of their billing issues if a provider did not submit the insurance I would find a new one ASAP.

I too have thought about getting insurance that would only cover a major illness and thus pay out of pocket for everything else. The problem is that I don't think our service providers would give us a big enough discount for it to make money sense. We don't have insurance coverage for eye care because we would spend more on the policy than in service.

Health Care is all messed up simply because there are too many fingers in the pie.

Later,
Dan

 

[dmccarty]

I'd say that doctor is a stand up guy! Normally they send it to collections and burn your credit.

Heres a short story I know for a fact:

BIL died of a heart attack 4 months ago. Last month his wife (SIL) is diagnosed with uterine cancer (advanced), she has 0 insurance and is basically broke. The quote she got from a N Texas hospital for their services was 34k, (estimated 3 day stay post OP) BUT since she has nothing, they will charge her 12k and change? The Doctors fee for the surgery would have been just under 7k, but they will do it in the $3,500 range. The difference is over 50%? She has purchased a surgical only insurance policy, but we haven't heard how this will effect the charges.

I submit to my fellow TBNers, that if the medical field would charge the lower rate ACROSS THE BOARD, this would certainly help this country's health care problem. I understand they may have to miss a vacation or 2, maybe use more tile in the Hospitals rather than carpet, and for some, it may be more difficult to get that extra "mountain house,,,but....Just thinking out loud.

For the record, I have 6 people in my immediate family in the medical professions.
...
Right! almost like "discrimination" against policy holders??

The reason they can lower the payment is because others are paying more. Look at Medicade/Medicare bill payments. They set a price level and they will pay no more. If the cost of service is more than what the Feds will pay, SOMEONE has to make up the difference or the service provider goes out of business. When I was in FLA for XMAS there were articles in the local paper about doctors who were no longer taking Medicare/Medicade patients because the doctors could no longer afford to provide care at the lower prices.

This whole thing is a mess.

Right! almost like "discrimination" against policy holders??

Never thought about it those words but it is the truth.

Later,
Dan

 

[Pirate]

After an accident, ins. co. man says tell hospital to bill medicare as soon as you can. The bill was 75K from hospital. Called and asked for some form of adjustment or negotiated fee. They said no way, pay it. They were told to bill medicare. The bill was only 26K at that point. Big difference.